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Eradication and graft retention can be achieved in the treatment for acute septic arthritis after primary posterior cruciate ligament reconstruction: analysis of 1561 reconstructions

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Acute septic arthritis after arthroscopic posterior cruciate ligament (PCL) reconstruction is a rare but severe complication. Optimal management has not been established. The purposes of this study were to analyze clinical findings and to retrospectively evaluate the graft-retaining treatment regimen.

Methods

From 2010 to 2021, a total of 1561 primary PCL reconstructions were performed at our institution. Seven patients with septic arthritis were identified and retrospectively analyzed with regard to incidence, clinical manifestations, treatment, postoperative clinical course and follow-up results.

Results

The mean interval from PCL reconstruction to the onset of symptoms was 11.0 ± 4.0 days. Staphylococcus aureus was the most commonly found pathogen. Eradication was achieved in all patients after a mean of 1.1 ± 0.4 procedures, with graft retention in all patients. The mean duration of antibiotic treatment was 5.7 ± 1.5 weeks. At the last follow-up, there was no recurrence, graft insufficiency or osteoarthritis.

Conclusion

Arthroscopic graft-retaining treatment combined with individual antibiotic therapy, eradication and good to excellent functional results can be achieved, which might encourage surgeons to try to retain the graft as much as possible.

Level of evidence

Level IV

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References

  1. Costa GG, Grassi A, Lo Presti M, Cialdella S, Zamparini E, Viale P et al (2021) White blood cell count is the most reliable test for the diagnosis of septic arthritis after anterior cruciate ligament reconstruction: an observational study of 38 patients. Arthroscopy 37(5):1522-1530.e2

    Article  Google Scholar 

  2. Barbara K, Alan I, Goran V, Saša J (2020) Knee infection following anterior cruciate ligament reconstruction: a cohort study of one thousand, eight hundred and ninety one patients from the single-centre database. Int Orthop 44(5):869–875

    Article  Google Scholar 

  3. Lo Presti M, Costa GG, Grassi A, Cialdella S, Agrò G, Busacca M et al (2020) Graft-preserving arthroscopic debridement with hardware removal is effective for septic arthritis after anterior cruciate ligament reconstruction: a clinical, arthrometric, and magnetic resonance imaging evaluation. Am J Sports Med 48(8):1907–1915

    Article  Google Scholar 

  4. Marom N, Kapadia M, Nguyen JT, Ammerman B, Boyle C, Wolfe I et al (2022) Factors associated with an intra-articular infection after anterior cruciate ligament reconstruction: a large single-institution cohort study. Am J Sports Med 50(5):1229–1236

    Article  Google Scholar 

  5. Paci JM (2021) Editorial commentary: synovial fluid white blood cell is the gold standard to detect infection after anterior cruciate ligament reconstruction: don’t hesitate to aspirate. Arthroscopy 37(5):1531–1533

    Article  Google Scholar 

  6. Schuster P, Geßlein M, Mayer P, Schlumberger M, Mayr R, Richter J (2018) Septic arthritis after arthroscopic posterior cruciate ligament and multi-ligament reconstructions is rare and can be successfully treated with arthroscopic irrigation and debridement: analysis of 866 reconstructions. Knee Surg Sports Traumatol Arthrosc 26:3029–3038

    Article  Google Scholar 

  7. Themessl A, Mayr F, Hatter K, Rupp MC, Pogorzelski J, Imhoff AB et al (2022) Patients return to sports and to work after successful treatment of septic arthritis following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 30(6):1871–1879

    Article  Google Scholar 

  8. Figueroa D, Figueroa F (2022) Postoperative infection after anterior cruciate ligament reconstruction: prevention and management. Instr Course Lect 71:489–495

    Google Scholar 

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Funding

Natural Science Basic Research Program of Shaanxi (Program No.2022JQ-865).

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Correspondence to Jiang Zheng or Liang Zhang.

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The authors declare that they have no confict of interest.

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Liang, Q., Kang, X., Zhao, Z. et al. Eradication and graft retention can be achieved in the treatment for acute septic arthritis after primary posterior cruciate ligament reconstruction: analysis of 1561 reconstructions. Knee Surg Sports Traumatol Arthrosc 31, 432–435 (2023). https://doi.org/10.1007/s00167-022-07059-3

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  • DOI: https://doi.org/10.1007/s00167-022-07059-3

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